Provider Demographics
NPI:1811174253
Name:UNIVERSITY SPINAL CARE CENTER
Entity type:Organization
Organization Name:UNIVERSITY SPINAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:SAINT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-360-3434
Mailing Address - Street 1:8441 HONORE AVE
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34201
Mailing Address - Country:US
Mailing Address - Phone:941-360-3434
Mailing Address - Fax:941-360-3433
Practice Address - Street 1:8441 HONORE AVE
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34201
Practice Address - Country:US
Practice Address - Phone:941-360-3434
Practice Address - Fax:941-360-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCHIROPRACTOR0007001111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5898Medicare UPIN